A 60-year-old white man with a past medical history significant for hypertension and hyperlipidemia presents to his family medicine physician with concerns about a 'spot' on his ear. He has been a construction worker for 35 years and spends most of his time outside. His family history is insignificant. On physical examination, there is a dark lesion on his left ear. The patient states that he has always had a mole in this location but that it has recently become much larger. A review of systems is otherwise negative. Which of the following lesion characteristics would be MOST reassuring among the given options?
ASingle, dark color
BChanging over time
CLesion asymmetry
DIrregular, indistinct borders
A 38-year-old man presents to the outpatient clinic for an annual employee health checkup. He does not have any complaints at the moment except for skin changes, as seen in the following image. He denies any history of trauma. His medical history is insignificant. His family history is negative for any skin disorders or autoimmune disease. He is a non-smoker and does not drink alcohol. Which of the following is the most likely mechanism for this presentation?
ADefect in melanoblast migration from the neural crest
BInvasion of the stratum corneum by Malassezia
CAutoreactive T cells against melanocytes
DMelanocytes unable to synthesize melanin
EPost-inflammatory hypopigmentation
A 53-year-old farmer presents to the clinic for evaluation of a pigmented lesion on his arm. He states that he first noticed the lesion last year, but he believes that it has been slowly growing in size. He otherwise does not have any complaints and is generally healthy. Which of the following findings on physical exam would suggest a malignant diagnosis?
ASymmetrical ovoid lesion
BFlat lesion with symmetric hyperpigmentation
CTenderness to palpation
DHyperpigmented lesion with smooth borders
EDifferent pigmentation throughout the lesion
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